Get your Health question answered in 3 easy steps

127 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Abdomen pains, black specks in stools. Faecal test negative. Advised for hydrogen breath test. What does it look for?

Answered by
Dr.
Dr. Poorna Chandra K.S

Gastroenterologist

Practicing since :2000

Answered : 339 Questions

default
Posted on Thu, 30 May 2013 in IBS(Irritable Bowel Syndrome)
Question: Dear Dr. XXXXXXX
I recently asked you regarding sharp pains in my abdominal area and unfortunately was busy so not able to follow up on your reply. You mentioned the hydrogen breath test. I thought this test was the same as the H.Pylori test but apparently it is different, what does the test look for? It appears to detect IBS mainly. How accurate is the test because it does seem like it's not totally proven.

I have mentioned to my doctor regarding the pains and the first step is the H.Pylori breath test, is this test able to detect past as well as present infection with the bacteria?

Also, I should mention that I have seen what look like black specks in the stool for a few months but the faecal occult blood test was negative so I assumed it was just food particles. Is it possible for the black specks to be bleeding very early in the gastro-tract that is solidified and hence can't be detected through the occult blood test? What else could cause the black specks?
doctor
Answered by Dr. Poorna Chandra K.S 3 hours later
Hi and thanks for the follow up
The breath test indicated was C14 breath test and it specifically looks for active H pylori infection. Past infection is of not much of a relavence as it is not associated with gastroduodenal problems. In an untreated case C14 breath test is a sensitive method to detect H pylori infection.
Stool occult blood is a chemical way of detecting blood as it looks at heam component. It is more specific for upper gastrointestinal tract bleeds than the distal colonic bleeds. Hence if multiple Stool occult blood are negative there is a less chance of any GI bleed. Then the black specks are more likely to represent some food residue
Regards
Dr XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Poorna Chandra K.S 15 hours later
Dear Dr. XXXXXXX

Thanks for the additional information. So, just to confirm, you would not recommend the usual hydrogen breath test in my case, instead the C14 breath test should be indicated. How would past H.Pylori infection be detected if at all? I understand that this type of infection greatly increases the risk of serious issues developing with the stomach or perhaps it's only active infection which increases risk.
Is there any reason why the occult blood tests are better at detecting the upper gastro-bleeds than lower colonic ones, perhaps including ulcers.


Thankyou.
doctor
Answered by Dr. Poorna Chandra K.S 10 hours later
Hi XXXXXXX
As I had written a healed H pylori infection is of not much consequence. However if you have to know both present and past infection go for H pylori serology test
For active infection C14 breath test or gastric biopsy and histopathological examination or a stool antigen tests are recomended. All have similar sensitivities but the breath test is the easiest to do
Regards
Dr XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Poorna Chandra K.S 34 hours later
Hi Dr XXXXXXX

Thanks. I have now found that I will do the C13 breath test soon. I wonder whether it's basically similar in sensitivity to the C14.
Just the past few days, I have experienced a dull pain about 6cms to the right and 10 cms above the navel, just below the rib bone. I am not sure if it's just temporary but would this be the area of the kidneys?
I have mild hydronephrosis of the right kidney.


Thankyou.
doctor
Answered by Dr. Poorna Chandra K.S 20 hours later
Hi
Both are equally good and difference is only in the way that it is measured.
Pain in the (R) upper quadrant can be because of a pathology in -
1) Liver
2) Gall bladder
3) Kidney
4) Stomach/ Duodenum
5) Head of pancreas
and Hepatic flexure of colon rarely
The characteristics of pain and associated symptoms help to make a probable diagnosis
Regards
Dr XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Poorna Chandra K.S 9 hours later
Dear Dr. XXXXXXX

Thankyou. I will investigate it further if it continues but I think there is a possibility it was caused by paracetemol intake. I have taken Norgesic, just one tablet for muscle stiffness but it does seem as if paracetemol has a possible effect on the liver or kidney in my case.

On another note, I believe I have asked you concerning GERD in the past, which I've also mentioned to my GP and the breath test is the first step. What is your opinion on Motilium to treat GERD, which was prescribed by an ENT specialist after viewing my throat through a scope together with nexium.

Also, can GERD or conditions of some acid reflux cause a feeling of fullness in the stomach and a sensation at the base of the throat just above the collar bone of wanting to burp but being unable at times. Also, there is an uncomfortable sharp rising sensation near this area after a swallowing motion without anything being swallowed which lasts for about 5 seconds where it rises in intensity before gradually going away. Or would these issues more be strictly to do with the throat?



Thankyou.
doctor
Answered by Dr. Poorna Chandra K.S 6 hours later
Hi and thanks for the query
Paracetamol is the safest NSAID with respect to GI side effects. Hence it is unlikely to c/be the cause of your symptoms
The ENT specialist was right in prescribing Motilium with Neksium. Use of a prokinetic (motilium) along with neksium will increase the response rate by around 15 - 20%.
A bad reflux or GERD and H pylori infection itself will cause the bloating and the throat discomfort. Hence plan and endoscopy and a biopsy for h pylori can be taken during the same procedure.
Regard
Dr XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,   ,   ,  
Drug/Medication ,   ,  
Lab Tests ,  
Medical Topics

Recent questions on  Nexium

doctor1 MD

i am a 40 year old white male with what i think is an ed problem but have an issue discussing it with my pcp. At times it takes oral stimulation to get an errection and sustaine a full erection.I went to the doc today for other issues and was prescribed nexium for a stomach issue and a antidepressat for anger issues

doctor1 MD

hello. i have many digestive problems. i am lactose intolerant, have acid relux disease, IBS, i take Nexium and have for the last 15+ years, i had my gall bladder out last July, but i still feel like it s there. by that i mean, my stomach gets that gurggly feeling after i eat anything. i really watch what i eat but i constantly feel bloated and gassy. what else can this be? i am so tired of feeling this way to the point that i want to give up eating all together, but if i don t eat, i get gassy too. ARGH! Any help you can provide would be greatly appreciated. Crystal

doctor1 MD

Can i have question.I have gastric, especially when after eat. My pain is cramp, n i suffering pain till feel dizziness. I go specialist check, have endoscopy. In scop, dr say i have GERD and h.pylori bacteria. So dr give me medication of nexium, gaviscon, and 2 type antibiotic(klacid). But seem no recover, still same situation happen. I when back see the dr, he advice me take 1 month nexium.But just few days when on, I suffer pain till non stop,is continuely especially is nite time. Until cant sleep because stomach is cramp. I meet back the dr., so the dr do ultrasound for my abdomen. But seem nothing. What should be happen?i suffering pain, is continue pain non stop. I be given another medicine, pariet 20mg, buscapon and gaviscon. but seem not work..What should happen with me??May dr give some opinion. I will be suspect stomach cancer? Latesly my dad also get stomach cancer, but when we know is too late. is already spread to his whole bone. So he pass away. My percentage should be high or not? What test i need to do??

doctor1 MD

I have been on nexium for two weeks and still have persistent heartburn. I had a EGD last Monday which reveal most things normal but an irregualr Z line (waiting for Biopsy). I am 48 year old female and suffer from migraines as well and have taken alot of Imitrex but am now just starting topamax - on the thin side, off of caffine and alcohol. Very worriied that the nexium isn't working yet.... and about my lab results. I was on Zegerid 2 years ago and it seems to work right away. I got a bit lax about coffee and tea and my heartburn returned and then after some serious nausea from a headache the heartburn set in terribly and has never subsided. Worried about GERD and Barretts

doctor1 MD

Hi! I recently started taking zoloft for anxiety and have found it to be very very helpful to me. One thing, however, is that it seems to cause a great deal of GI problems for me. I am taking severe severe bloating , gas, indigestion and some...

doctor1 MD

I was diagnosed with GERD and had the Nissen Fundoplication surgery 6 weeks ago to fix my hiatal hernia . Since the surgery I still have the same exact symptoms I had before and I'm taking the same amount of acid medication as before to control...

doctor1 MD

I am 60 very athletic. I shoveled this morning and came in light headed, with ears ringing louder than normal. I feel and have felt a sense of anxiousness. I had some tingling in my right fingers though started some r shoulder exercises yesterday....